High-velocity trauma does form a major cause of such bilateral injuries, however, nutritional deficiencies and metabolic causes should be kept in mind while treating such a rare pattern of injury.
Considering the bilateral nature of the injury and a borderline age with limited remodeling potential, a lower threshold for conservative therapy must be adopted in young active individuals. High-velocity trauma does form a major cause of such bilateral injuries, however, nutritional deficiencies and metabolic causes should be kept in mind while treating such a rare pattern of injury.Pediatric floating elbow in the setting of flexion type-supracondylar fracture is exceptional. Most reported cases in the literature include the more common variant of supracondylar fracture which is the extension type. We report a rare case of pediatric floating elbow associating flexion type supracondylar fracture with both bone forearm fracture and ulnar nerve irritation.
A 5-year-old boy presenting to the emergency department after sustaining a fall from 3 m height. At presentation, he had an S-shaped deformity of the left upper limb, along with ecchymosis of the medial side of the elbow and the anterior aspect of the forearm. He was also complaining of severe pain with numbness in the territories of the ulnar nerve at the level of the wrist and hand without any signs of the median nerve or radial nerve neuropraxia or injury. The primary assessment demonstrated left flexion type supracondylar fracture, along with ipsilateral radial shaft fracture and ulnar shaft fracture. The patient was treated surgically by open reduction internal fixation of the supracondylar fracture followed by closed reduction and fixation of both bone forearm fracture.
This case is reported for the unique association of flexion type supracondylar fracture - a rare type of supracondylar fracture in children - with ipsilateral both bone forearm fracture in a setting of the floating elbow and a relatively low incident complication which is ulnar nerve neuropraxia.
This case is reported for the unique association of flexion type supracondylar fracture - a rare type of supracondylar fracture in children - with ipsilateral both bone forearm fracture in a setting of the floating elbow and a relatively low incident complication which is ulnar nerve neuropraxia.The incidence and outcome of infection in open tibial fractures is adequately recorded in literature. The aim of this study is to find out the deep infection rate, union rate, and functional outcome of open tibial fractures managed by prophylactic antibiotic eluting interlocking nail.
A total of 18 patients with 20 open tibial fractures who met the study criteria were included and followed up for a minimum of 1 year after surgical intervention. Reamed intramedullary interlocking nailing with antibiotic eluting nail was done followed by adequate skin cover.
The outcomes were assessed using lower extremity functional scale and radiological union scale in tibial fractures both of which showed maximum improvement in initial 3 months followed by a steady improvement till 1 year with a good degree of correlation between the two scales. The total incidence of deep infection in this study was 5% (n = 1). All cases achieved union and independent ambulation by 1 year.
Our study shows good radiological and functional outcomes with prophylactic antibiotic-coated nailing of open tibial fractures of Grades II and IIIA. The rate of deep infection is 5% and union rate is 100% in our study. Further comparative studies are required for drawing more conclusions on application of the results in clinical practice.
Our study shows good radiological and functional outcomes with prophylactic antibiotic-coated nailing of open tibial fractures of Grades II and IIIA. The rate of deep infection is 5% and union rate is 100% in our study. Further comparative studies are required for drawing more conclusions on application of the results in clinical practice.Trochanteric femoral nail-advanced (TFNA) was introduced in the market with better nail design, better alloy (titanium molybdenum) and both sliding and static locking options of the helical blade. Although, it was devised to overcome the shortcomings of roximal Femoral Nail Anti-rotation (PFNA), it still can have complications, if the principles of fracture management are not met. Here, we report a case of a TFNA implant failure with helical blade cut-out in an elderly osteoporotic patient treated for inter-trochanteric femur fracture. To the best of our knowledge, this is the first report of helical blade cut-out wit TFNA nail in world literature.
An 83-year-old female patient was treated with a TFNA nail for inter-trochanteric femur fracture (AO 31A2.1). An acceptable reduction and stable fixation were achieved. The position of the helical blade in the head was in the optimal position with a tip apex distance (TAD) of 29 mm. The patient presented to us 6 weeks later with implant failure with helical blagment which collapsed into varus, leading to cut-out. https://www.selleckchem.com/products/Methazolastone.html This case report emphasizes the importance of TAD, valgus reduction, and positive variance in avoiding implant failures, even with a newer implant like TFNA which was developed to improvise onto the shortcomings of PFNA nail.Osteoid osteoma is a benign bone tumor. It occurs in epiphyseal and metaphyseal regions of long tubular bones of extremities. Around 10% of osteoid osteomas present in spine. In the spine, 2% of cases involve sacrum. Here, we present an atypical case of osteoid osteoma in the sacrum.
A 15-year-old boy presented with complaints of low back pain with a 1-year duration, radiating to the left thigh. MRI and CT-scan were suggestive of osteoid osteoma at S1-S2. Pre-operative localization of the tumor was done under CT-guidance under local anesthesia with three spinal localized osteoid osteoma was marked with methylene blue. Dissection of complete osteoid osteoma was done, along with sclerotic margin and sent for histopathological examination which was conformed osteoid osteoma. Post-operative CT-scan showed complete removal of osteoid osteoma. At 1-year follow-up, the patient was asymptomatic with no evidence of recurrence.
The CT-guided pre-operative localization of osteoid osteoma of the sacrum is an interesting treatment option.